Nystagmus

Published January 4, 2021

What is nystagmus?

Nystagmus is an eye condition that causes repetitive involuntary eye movements. These movements can cause the eyes to move from side to side, up and down, or in circular motions.

Nystagmus frequently leads to unsteady and impaired vision and depth perception which can cause poor balance and coordination.

Many people with nystagmus hold their head in unusual positions to help them compensate for their unstable vision.

Symptoms of nystagmus

  • Involuntary eye movements in one or both eyes
  • Reduced vision
  • Blurry or shaky vision
  • Light sensitivity
  • Impaired night vision
  • Poor depth perception
  • Dizziness and imbalance
  • Impaired coordination

Types of nystagmus 

Congenital (infantile) nystagmus

Nystagmus that begins in infancy can be seen in babies as young as 2 or 3 months old. Congenital nystagmus is typically characterized by horizontal swinging eye movements.

It is frequently caused by a congenital cataract, congenital absence of the iris, underdeveloped optic nerves, or albinism.

Spasmus nutans 

This type of nystagmus develops in children between 6 months and 3 years of age. Children with spasmus nutans will present with eye movements in any direction, and will frequently tilt or nod their heads to compensate for their unsteady vision.

This form of nystagmus generally does not require any treatment and will usually improve by the time the child turns eight years old.

Acquired nystagmus

This form of nystagmus develops later on in childhood or adulthood, and can cause involuntary eye movements in any direction.

While the cause is often unknown, it is usually associated with central nervous system conditions, metabolic disorders, or drug and alcohol toxicity.

What causes nystagmus? 

When present at birth or in early childhood, nystagmus is generally caused by a neurological condition.

Acquired nystagmus is usually a symptom of another eye or medical condition, such as trauma, stroke, or multiple sclerosis.

In many cases, fatigue and stress can make the nystagmus worse and the involuntary eye movements more severe.

Other causes of nystagmus may include:

  • Albinism
  • Congenital cataracts
  • Underdeveloped eye movement control
  • High myopia (nearsightedness) or astigmatism
  • Inner ear inflammation
  • Certain medications, specifically those used to treat epilepsy
  • Central nervous system conditions

How is nystagmus diagnosed? 

If you are experiencing symptoms of nystagmus, schedule an eye exam as soon as possible. 

Your optometrist will conduct a thorough assessment of your vision and eye movements to determine how much of your vision is being affected by the condition.

Be sure to inform your eye doctor of your past medical history and any medications you are currently taking.

Since nystagmus is usually a symptom of another condition, your optometrist may refer you to another medical specialist for further testing— which may include an inner-ear exam, neurological evaluation or brain MRI.

Treatment

Some forms of nystagmus will improve over time, without any medical intervention or treatment. In some cases, eyeglasses or contact lenses may be prescribed to improve vision affected by the nystagmus.

Neuro-optometric rehabilitation

Neuro-optometric rehabilitation has been shown to improve the visual function in patients with nystagmus.

This specialized form of therapy trains and strengthens the neural connections between the eye and brain to improve the visual skills necessary for clear and comfortable vision.

Surgery

In rare cases, surgery to change the position of the eye muscles may be recommended to improve eye movements for clearer, more comfortable vision.

If you or your child is experiencing symptoms of nystagmus, schedule an eye exam as soon as possible. 

Your eye doctor will help you to determine what may be causing the involuntary eye movements and guide you toward the most appropriate management and/or treatment options.